Managing the risk of suicide in a psychiatry clinic: an ethnographic study on the work atmosphere of nurses during the pandemic period

Introduction It is known that the restrictions and clinical changes experienced during the pandemic period have negative effects on the care and treatment of psychiatric patients. However, insights on how the pandemic environment and the approaches of healthcare professionals serving during the pandemic affect the care and treatment of patients at risk of suicide are insufficient. Objectives This ethnographic study aimed to identify the approaches of psychiatric nurses in managing suicide risk during the pandemic period in relation with their work environment. Methods This ethnographic research design used a sample of 13 psychiatric nurses in a psychiatric clinic in Ankara. Data were collected with in-depth interviews, participant observations and observant participations. Data were obtained from a total of 612 hours of observation and 13 planned nurse interviews. Data were analyzed using qualitative thematic analysis. Results The emergent main theme from data analysis is explained under the title of “The risk of loss of inauthenticity in suicide risk management”. “Risk of loss of inauthenticity” means the fact that the individual suicidal risk factors and differences of the patients cannot be perceived/assessed by the nurses. Conclusions Supposing all patients having the same suicide risk level by psychiatric nurses caused insensitivity to risky patients in the care process. Nurses’ inadequate approach to patient personality disorder and limited social interactions due to the pandemic atmosphere made it difficult for nurses to have knowledge and understanding of how patients cope with suicidal ideations. These findings show the importance of the use of valid and reliable scales with risk formulations and the significance of triage in crisis periods such as current pandemic. In addition, creating available online consultancy service alternatives may have an important role in the management of suicide risk for patients who are disturbed by long-term hospitalization. Also these findings may contribute to the creation of qualified care and treatment guidelines on suicide risk management for crisis periods. Disclosure of Interest None Declared

Introduction: Suicide is recognized as a social problem and the interest in preventive measures to diminish suicide risk is constantly increasing. But scientific research results that distinguish between those who have only suicidal ideation (SI) and those who have a history of Suicidal attempts (SA) are limited. Inhibitory control is regarded as an important ability related to the transition from suicidal ideation to suicide attempts. In event-related potential, patients with dysfunction of inhibitory control demonstrate a reduction in the no-go amplitude.
Objectives: This study aimed to determine the association between the no-go event-related potential component and suicidal behaviors among suicide attempters and ideators who never attempted suicide. Methods: Overall, 150 patients who visited the emergency room by suicide attempts or patients who visited the psychiatric department with suicidal ideation were recruited and instructed to perform a go/no-go task during electroencephalography recording. The Beck Depression Inventory, Beck Anxiety Inventory, Barratt Impulsivity Scale, Difficulties in Emotional Regulation Scale, and Acquired Capability for Suicide Scale were used. Individuals were divided into two groups: those with suicidal attempts (SA group) and with suicidal ideation (SI group) without SA. The psychological characteristics and event-related potentials of the two groups were compared. Correlation analyses were conducted to test the association between the clinical characteristics and event-related potentials.
Results: The SA group had significantly decreased no-go P3 amplitudes at all electrodes compared to the SI group. In the correlation analysis between the clinical measurements and event-related potentials in all the participants, no-go P3 amplitudes in whole electrode sites were negatively correlated with the scores of the acquired capability for the suicide scale.
Conclusions: This study revealed that suicide attempters have dysfunction in controlling inhibition compared to suicide ideators reflected in the no-go P3. Our findings suggested that no-go P3 can be a biomarker associated suicide attempts in suicide ideators.

EPP0776
Managing the risk of suicide in a psychiatry clinic: an ethnographic study on the work atmosphere of nurses during the pandemic period S. Öztürk 1 *, D. Hİçdurmaz 1 and M. Soileau 2 Introduction: It is known that the restrictions and clinical changes experienced during the pandemic period have negative effects on the care and treatment of psychiatric patients. However, insights on how the pandemic environment and the approaches of healthcare professionals serving during the pandemic affect the care and treatment of patients at risk of suicide are insufficient. Objectives: This ethnographic study aimed to identify the approaches of psychiatric nurses in managing suicide risk during the pandemic period in relation with their work environment. Methods: This ethnographic research design used a sample of 13 psychiatric nurses in a psychiatric clinic in Ankara. Data were collected with in-depth interviews, participant observations and observant participations. Data were obtained from a total of 612 hours of observation and 13 planned nurse interviews. Data were analyzed using qualitative thematic analysis. Results: The emergent main theme from data analysis is explained under the title of "The risk of loss of inauthenticity in suicide risk management". "Risk of loss of inauthenticity" means the fact that the individual suicidal risk factors and differences of the patients cannot be perceived/assessed by the nurses. Conclusions: Supposing all patients having the same suicide risk level by psychiatric nurses caused insensitivity to risky patients in the care process. Nurses' inadequate approach to patient personality disorder and limited social interactions due to the pandemic atmosphere made it difficult for nurses to have knowledge and understanding of how patients cope with suicidal ideations. These findings show the importance of the use of valid and reliable scales with risk formulations and the significance of triage in crisis periods such as current pandemic. In addition, creating available online consultancy service alternatives may have an important role in the management of suicide risk for patients who are disturbed by longterm hospitalization. Also these findings may contribute to the creation of qualified care and treatment guidelines on suicide risk management for crisis periods.

Disclosure of Interest: None Declared
European Psychiatry S499